Well after years of snoring complaints (although none by my sweet wife) I gave in and went to a sleep center. Cigna denied an in-center test so I was given a home strap-on test system. Results were 63 AHI and 62% oxygen.

So no titration test, the DME (Apria) hands me an APAP set to 5-20. I picked the Amara FF mask (still a serious deviated septum after one surgery attempt). After eight days I have a tender nose bridge and struggle with leaks over 10cmH20. Tough to install the mask at 5cmH20 and not have issues at 13 in the middle of the night. I'm going to go back and try another mask.

AHI still running at 8 to 15, but its only been 8 days.

I certainly appreciate this website and the admin emailing me the clinician manual. While I don't intend to play doctor I did bump the minimum up to 6 last night as at 5 it seems like I wasn't getting enough air. Should I set that back to 5 before I go in to the doc in 60 days? I don't want them getting upset.

I do think my attitude is better already and my after-lunch alertness is improved. One other major advantage is NO trips to the bathroom at night, whereas I as getting up every two hours before.

Check to see if you have the ramp on. If you do, try turning that off. That may help with the feeling of no air.

Make sure you don't have the straps too tight. Masks are designed to "float" on the face. When the air comes in, they kinda inflate the inside flap thingy that forms the seal. Over tightening can break that seal and make it hard for it to form.

I think all of us go through a LOT of masks before we find the right one. Keep trying, don't give up. Lots of folks here like the two Quattro masks.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

(12-10-2013 11:43 AM)Redonthehead Wrote: I do think my attitude is better already and my after-lunch alertness is improved. One other major advantage is NO trips to the bathroom at night, whereas I as getting up every two hours before.

Hi Redonthehead
Congrats, these are good signs that the therapy is working for you

Don,t worry about numbers at this stage, finding the right mask is most important, might take few trials with different masks

Check if "mask fit check" turned on, in the clinical menu. You don,t want to over tighten the straps, cushion designed to seal inflated with air, if straps are too tight would leaks more ... washing the cushion daily is recommended for better seal
Amara fitting guide http://www.theanswer.philips.com/amara/right_fit.html

Hi Redonthehead,
WELCOME! to the forum.!
It sounds like you are off to a good start, just keep on going and don't be shy about trying as many different masks as it takes 'till you find the one that works for you.
Best of luck to you with your CPAP therapy.

You can download SleepyHead software and watch your data that will give you info on leaks, AHI, etc. How does your insurance company expect you to get proper treatment without knowing your optimal pressure or at least a pressure to start with? I don't know much about in home testing and what info is gotten by them. Hope you have great success with Apria.

The Gecko nose protector is $16 from Supplier #2 on our Supplier List (link at top of all forum pages). Eliminates leaks around the eyes. Lasts about 1 or 2 months until gets too soft and stretchy to work well.

I use Quattro FX FFM with RemZzz mask liner to control leaks (without needing gel pad). RemZzzs last me 3 or 4 days until they get stretched out of shape and don't seal as well.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.

(12-10-2013 11:43 AM)Redonthehead Wrote: I certainly appreciate this website and the admin emailing me the clinician manual. While I don't intend to play doctor I did bump the minimum up to 6 last night as at 5 it seems like I wasn't getting enough air. Should I set that back to 5 before I go in to the doc in 60 days? I don't want them getting upset.

My Doc wants me at constant 12, but that pressure pumps up my stomach with and actually comes blowing out of my tear ducts in my eyes! Doc had changed my pressure to auto-titrating range of 5-20. I was still getting AHI between 6-8. With my clinicians manual in hand, I raised my minimum pressure from 5 to 8.

Its only been two nights, but nite# 1 I had AHI=2.5 and nite #2 AHI=3.1

I learned how to "crack" the clinicians interface in order to see my numbers, and it has helped a great deal. Thanks to ApneaBoard!

I encourage you to go ahead and "play doc". I have a feeling that some of the resistance to letting us see and set our numbers is that it means fewer visits for sleep studies, and lower profits for the medical provider clinic.

bobzzz are you looking at your data? if not, you may want to download ResScan and/or SleepyHead and look at your data. Look at your median, 95% and max pressure and see what those numbers are. I would look at those numbers for a few weeks and see what they are and then adjust your pressures according to that data. Since your doc wants your pressure at 12, I would set your machine at 11 for the low number. Then, watch your data and see what your high pressure is and then determine your high pressure number. Right now, you have a big range for your pressure settings. You can tighten that range up by watching the data. I wouldn't set your low pressure below 11 though if it were me. Just a few suggestions.

(12-11-2013 09:56 AM)bobzzz Wrote: Doc had changed my pressure to auto-titrating range of 5-20. I was still getting AHI between 6-8. With my clinicians manual in hand, I raised my minimum pressure from 5 to 8.

Its only been two nights, but nite# 1 I had AHI=2.5 and nite #2 AHI=3.1

Hi bobzzz,

Sounds like the 8-20 range may be working well for you. Although increasing the minimum to 8 likely improved your AHI, I wouldn't raise minimum higher than 8 just yet. I would watch the data for a week or two before perhaps raising minimum to 9 and watching another week or month.

The originally-prescribed fixed pressure of 12 was probably chosen to be high enough to avoid apneas while you were sleeping in the supine position, when gravity tends to pull our relaxed tongues back and increase our pressure needs. One way to lower your pressure needs (so that a minimum of 8 may be adequate rather than 11 or 12) would be to stay off your back while sleeping.

I wear a slightly snug teeshirt with a tennis ball in a pocket sewn right between the shoulder blades, to definitely keep me from rolling onto my back while asleep.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.

Thanks for all the input. I was able to borrow a couple of masks from the sleep doc and found the Quattro FX much better than my PR Amara. No nose bridge pain at all. My DME (Apria) had a new FX delivered to my house in one day.

The FX is fine but sometimes does ride up the nose and occasionally rubs the top of the ear. I would like to try the Quattro Air sometime. I had leak issues with the Quattro Mirage.

I decided I could bear with the 5-20 pressure range until my 60 day appointment with the doc. I don't want the insurance police on my case. They are watching closely during this initial period - actually called the other day and told me how well I was doing (there is a cell phone attached to the System One unit they can access and look at the data.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.